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June 18, 2008

What Do Patients Really Want?

Manoxygen72x721 Have you ever thought about what your patient in Room 9 really wants most? What the retired police officer waiting for a heart transplant in Room 16 wants? How Bill, who has suffered with hemochromatosis for 11 years and  just been readmitted for mild liver failure, wants?

The results of a study in the UK of 1000 patients tell us that the number one thing patients want is thoroughness. That actually surprised me. I'm thinking that perhaps what those who have a national healthcare system (as they do in Great Britain) want, and what we Americans who have a private system want may be two different things.

In order after thoroughness, here is what British patients report as most valuable:
* Seeing a doctor who knows them well
* Seeing a doctor with a warm and friendly manner
* Having a shorter waiting time for an appointment
* Having flexibility in selecting appointment times

Hmmm.... as a nurse, knowing what I know, and working in the environment I work in, my values are a bit different, as follows:
* I want a doctor (or other provider) who is competent and knows what she/he is doing
* I want a doctor who can explain to me what is going on in my body and what my options are for fixing it
* I want a doctor who will take enough time to oversee my treatment so that no mistakes are made: no drug errors, no surgical errors, and no infections acquired if I have to be in the hospital
* I want a doctor who will coordinate my care, follow up when I've been to see another doctor, and help me keep the big picture in mind so I'm not being treated by drive-by specialists.

For those of you who have had the experience of being a patient, what have you wanted? Specifically—what have you most wanted from your nurses? (Let’s skip the doc part!)

Source: What Do Patients Want From Doctors?

June 18, 2008 in Beka | Permalink

Comments

Most of the times medical authorities will be responsible for problems like medical malpractice.

Posted by: Medical Malpractice Claims | Jun 10, 2011 2:56:36 AM

The surgery itself is where poor pre-operative planning may come to light, but a surgeon performing an operation may also be negligent in his duty of care to the patient. There are many instances of mistakes made during surgery which were completely avoidable and which led to a serious long term health issue in a patient or even death. Surgical tools and implements have also been known to be left in patients after an operation, and these may not be discovered for many years – if at all.

Posted by: surgical errors | Mar 17, 2011 8:21:04 AM

The doctors should be really very careful while doing operations.Although usually not so common, but equally dangerous, are mistakes that are made in post-operative procedures. The introduction of excessive antibiotics or painkillers can have an adverse effect on a patient’s recovery, and mistakes made in treating surgical wounds can lead to haemorrhaging around the area which was operated on – particularly in operations which have been performed using laparoscopic or “keyhole” procedures where the area of surgery is not so apparent.

Posted by: surgical errors | Mar 16, 2011 5:41:54 AM

Well, I have thought about this a bit more after being hospitalized for Thyroid Storm almost 20 years ago.

1 ) I want a competent, compassionate , skilled nurse. No nurses working mandatory OT, 24 hour shifts need apply.

2 ) I want a clean room- no flies, lice, mice, maggots or dust balls. A daily housekeeper would be nice !

3 ) I want flexible visiting hours, if need be.

4 ) I don't want all my colleagues visiting me. I want to heal in peace with my family nearby.

5 ) I want empty garbage cans that aren't overloaded with garbage, dressings for hours that sits for hours etc. waiting to be emptied by housekeeping.

6 ) I want a good meal. Ensure would be a plus ! Strawberry-flavored please !

7 ) I want to meet the head or the charge nurse each shift , just to introduce her/him self and to reduce the stigma of a nurse as a patient !

8 ) I want an adequate linen supply during my stay.

9 ) I want .....hot water to run from the sink.

10 ) I want....

beka

Posted by: beka | Jul 17, 2008 5:07:41 PM

I certainly hope that my nurse will turn on the lights to assess me if I am in ICU--there is more to an assessment than temp and B/P, no matter what time it is.

Posted by: Rae | Jul 14, 2008 4:54:51 AM

After twenty plus years in active nursing it has been daunting being the patient on a number of occasions in different hospitals. What I was expecting was kindness, gentleness, tolerance and efficiency. What I got most of the time was attitude -if I did not fit their notion of how I should be (I had a hard to diagnose condition). Now am unable to nurse actively but I try to be an advocate where possible for others. It is just as difficult to observe the rudeness and harshness that I observe towards others as it was to experience it. Now I am shocked if a caring,polite nurse presents. I try to stay as healthy as I can so as to remain out of hospitals.

Posted by: Maggie | Jul 11, 2008 9:56:06 AM

Having experienced a recent ICU stay with my 18-year old son, being a patient advocate was only to his benefit. The care he received was for the most part excellent, but I had to assert myself many times to ensure that total patient care was being practiced - i.e., he had not urinated in over 12 hours - do you think anyone had addressed it? His age was to my disadvantage as the nursing and medical staff talked only to him as if I were invisible; the staff had to ask his permission to have me present to discuss his care - HIPPA has it's place but this was definitely not the time or place when immediate care was necessary. As a hospital nurse, I work with the patient AND their family who usually have a baseline of information to navigate through a very rushed healthcare system. My definition of a patient therefore is not just the person being treated, but the immediate significant others within HIPPA guidelines. I can say I expect the same from staff when my family is hospitalized.

In these times of Public Relations and patient satisfaction surveys, it is very challenging to meet both public and mgmt. expectations while providing safe patient care.

Posted by: Joyce | Jul 7, 2008 2:23:29 PM

Reading some of the posted hospital experiences makes me want to run as far as possible from today's medical facilities. Nurse competency is an issue, but even greater is the issue of staffing in relation to patient acuity.
Maybe those receiving dissatisfactory care in a facility that promotes itself as being no. 1, no. 2, or no 3 within yearly US Hospital Reports should take legal measures to hold them accountable for safe quality care? That would certainly bring a wake-up call to healthcare and the general public, as would using the media. No facility wants their public image affected by these tales of horror.

Unfortunately, we, as nurses, are sleeping, passive giants, YET the power to impact change is there.

beka

beka

Posted by: beka | Jul 6, 2008 4:38:01 PM

I am hearing more and more comments from patient families and patients themselves, about the "good ole days of being admitted to the hospital. What DID happen to those good ole days in nursing? Who wants to sit in a holding area for 3 days with racking pneumonia before getting a bed?

Has cost cutting really impacted the workings of medical centers and the decision makers who continue to seem as clueless as can be about the current crisis in
the nursing shortage...?

beka

Posted by: beka | Jul 2, 2008 9:42:14 AM

Of interest to anyone facing hospital admission:

http://grabsomehealthnews.blogspot.com/2008/06/new-medicare-rules-mean-better-hospital.html

Posted by: Kathleen | Jun 26, 2008 11:29:57 AM

All of these comments are excellent. I have to agree, that staffing ratios seem to be limited, making it more difficult to deliver optimal care in a hospital setting. My heart especially goes out to Barb, who was treated so poorly. Pain management is a serious issue, and I have heard fellow nurses berate patients who need intensive pain control.

Standards of care seem to have changed. I have had younger nurses absolutely refuse to provide information to patients regarding their condition. I'm not sure why! I have recently worked in a Cardiology setting (office), and had patients call me from their hospital beds to find out "what's going on" with their care, telling me they cannot get information from the attending nurse.

I haven't been a patient for many years, but my mother has. She had surgery - following her discharge from ICU, her level of care drastically waned. Examples include severe constipation from pain medication, though I "begged" her nurses to start her on a bowel regimen, inadequate pain control once she was on the med-surg floor, and way less frequent visits to encourage deep breathing and cough-even though she had a chest tube in place.

I too believe nurses do the best they can, and that prioritizing is mandatory. I have taken exception with staffing according to patient acuity, rather than the volume of patients, for years. I think it's a bad idea, and encourage all patients to seek a patient advocate. You can read about it at this link:

http://www.patientsafetyadvocate.org/Advocacy%20Training.html

It is a wonderful tool for patients and families.

Re: hulatalulala's question - experiences in the emergency department and in outpatient settings can be just as frustrating. Too little time is spent by physicians during office visits. Inadequate history taking often ensues. A recent survey shows that physicians spend an average of 2.5 minutes obtaining a health history from a patient in the office. How can you address risk factor modification if you don't have a thorough family history? We have great tools for disease prevention, but can't implement them without the ability to take time for truly individualized care, but productivity is too often the bottom line.

Posted by: Kathleen | Jun 26, 2008 11:26:35 AM

I am a hospital based nurse who had a total knee replacement 3 1/2 years ago. I still have nightmares regarding the treatment I received. I am on high dose Morphine for a condition unrelated to my knee. Aside from giving me generic morphine that I told them didn't work as well, they gave one of my meds as a prn, instead of a scheduled dose. This went on for 4 days before they realized this. One med I didn't receive for 4 days because it wasn't in the hospital formulary and between the 2 med errors, I went into severe withdrawl. Because I had been on the high dose Morphine for 10 years, I was treated like a junkie and at one point the nurses took it upon themselves to decrease my Morphine because they thought that I was on it for my knee, not another condition. As a nurse, I know how busy the floor staff can be, but during 8 days in hospital, there were so many mistakes and condescending attitudes that I was scared for my life. The only staff that listened or picked up on problems were the physiotherapist and the pharmacist. I ran a temp of 104 degrees F for most of my stay and nobody did anything.
Unfortunately, I never received an apology or any better care during my hospital stay. At one point they almost killed me. As an aside, my Morphine is prescribed by only one physician who is a world reknown neurologist. Unfortunately, he didn't work at that hospital.

Posted by: Barb Klick | Jun 26, 2008 4:24:14 AM

When my mother was in ICU and on the cardiac floor prior to her death this year, she had excellent nursing care, however, I felt that when she was on the floor it was crucial to have a family member there with her at all times, as the nurses were spread pretty thin.
I cannot say enough nice things about the cardiac ICU nurses and the care they provided not only to my mother but to all of us in the family when her death was near...Competence and compassion..and sensitivity to her needs and ours....

Posted by: Brenda | Jun 25, 2008 10:36:35 PM

I was recently discharged from a psychiatric hospital having suffered depression. On admission I was frightened and extremely anxious. The caring nursing, therapy and medical staff made this process much easier.
So what did I want from hospital staff -

People who care about you and who make you feel comfortable when your usual role is reversed.

People who explained everything - how I was experiencing physical symptoms for a mental health condition and the side effects of all my new medications.

People who treated you as a person with choice, allowing you to have input into the treatment you received.

People who were unobtrusively observing and noticed when you were having a bad day.

Knowledgable and competent staff for whom nothing was too much trouble.


I was lucky and received this care, allowing me to start the recovery process.

Posted by: Karen | Jun 25, 2008 8:48:24 PM

I was surpried by all the negative comments posted about nurses. Being a hospital nurse myself I know that it is a goal of mine to provide the best care possible. To put all the blame on nurses for a lack of quality care to me shows a misunderstanding of the health care system. Doctors, pharmacists, ect. make and are capable of making just as many mistakes as a nurse can. Nurses carry a tremendous amount of responsibility. If a doctor makes a mistake the nurse has to catch it, if a pharmacist makes a mistake the nurse has to catch it. If not the nurse is often blamed for what really was the responsibility of other members of the health care team. Pain management is a high priority where I work, but in any given day I'm carring for several pateints at one time. If I have a patient in pain and one with a more life threatening issue developing - I have to treat the most life threatening first. It doesn't mean I have a disregard for the patient in pain or that I lack compassion or don't care. I have to prioritize, and unfortunately can't be everywhere at one time. With this said, I also must agree that not all healthcare out there is carried out to the standards that it should and I agree that any patient should have and deserves the best care possible. Every patient should be their own advocate however and take the time to research themselves and never be afraid to ask questions or ask for another nurse or a second opinion if you don't feel you are getting the care you deserve.

Posted by: jessie | Jun 25, 2008 4:33:06 PM

First I want medically knowlegeable, competent nurses who also know how to manage their time and delegate appropriately. When I had a hysterectomy I was left alone most of the time after being brought to my room. I was told that I would receive pain medication every 4-6 hours. In the middle of the night my call button was on the floor and I was in pain. It took me over an hour to figure out how to retrieve it. Once I did, I rang for assistance, every 15 minutes (and I could hear the call bell being turned off from outside) for 1 1/2 hours. By the time my husband walked in at 7:30 AM He took one look at me a hollared for assistance. My physician showed up at the same time, and it was only then that I got the PCA that had been ordered.
I then became a nurse in the same hospital post-surgical unit and I was often shocked at the disregard shown by nurses and aides to ringing call bells and patient's c/o pain. It is also discouraging to see how many nurses lack a good understanding of physiology, the disease process, and the most common complications of the various surgeries. I find myself sympathysizing (?) with many of the physicians who must trust their patients in the hands of these nurses. It is my hope that we can raise the professional standards and performance of the profession and attract truly high quality candidates.
LMS

Posted by: Lynn | Jun 25, 2008 1:06:03 PM

In defense of health care professionals everywhere, I have been a bedside nurse for 25 years and have seen tremendous change in the industry.Simply, hospitals are businesses and want to make as much money as possible so the nurses and healthcare providers as well as the ever important, patient suffer!!!! My hospital seems concerned with getting a patient out as fast as possible so that the next patient can come in and begin payment. Some physicians are reimbursed more dollars for discharging the patient as soon as possible. There are people running around in the hospital whose sole purpose is to see if the tentative discharg is being expeditated fast looking at all ways to get the patient out!!!!All nurses really want is to take care of their patients effectively and to the best of their ability but hospitals seem to tax them with other duties,that subtract from patient care. I am tired of being blamed for things that are out of my realm . So the next time someone gets down on the nurse and other ancillary services of the hospital, think again...It might be the people at the top who need the critism.

Posted by: Val | Jun 25, 2008 11:42:39 AM

A Tale of 2 (or 3) ED Nurses
Within the last month I spent most of a weekend in and out of the ED at our local tertiary care hospital with my multiply handicapped adult son. First ED visit the problem I wanted addressed was severe constipation with possible urinary retention. Everyone focused on the constipation so I assumed htey didn't think urinary retention was an issue. By 3am I was pretty sure by feeling my son's abdomen that he had retained urine. I asked the (male) nurse to put in a catheter. He did but got onoly a couple table spoons of dark urine. I was surprised, but figured I must be interpreting my son's stomach signs incorrectly. I am not a nurse, just a mother, after all. We went home but were back at the same ED about 30 hours later. This time I was certain my son had retained urine, since I had been with him continuously and he had not pee'd. On the 2nd visit tot he ED the triage nurse (also male) took one look at my son's tummy and whisked us into a treatment room while he quickly got another nurse to start a catheter before going back to his triage station. The nurse (female) who placed the catheter this time got over 2 liters of urine. When I asked her about the lack of results the day before, she told me that it is possible to insert a male urinary catheter so that it is not all the way into the neck of the bladder. In a person with severe constiopation and urinary retention, this could result in the kind of minimal output we saw. My son narrowly escaped a ruptured baldder. He suffered intense discomfort for nearly 30 hours that could have been avoided if the first nurse had placed the catheter correctly. My son is non-verbal and has a high tolerance for pain as part of his neurological ocndition, but that is no excuse for incompetent care. On my part, I trusted that any RN working in an ED would know how to correctly insert a urinary catheter. I won't do that again. What do patients want for their vulnerable loved ones? Competent, compassionate care. How much better it would have been for all of us if the 1st nurse had said something like, "I think I need to get another nurse to assist me with this procedure." Then he could have asked a colleague to help him get the catheter placed correctly. Either he over estimated his ability, or he did not even realize he had not inserted the catheter correctly. Either situation is dangerous for patients like my son.
So that's what I'm looking for - competence first, informed by compassion.

Posted by: SHBB | Jun 25, 2008 9:57:19 AM

I would advise taking a good friend along with you to help protect you from any and all hospital employees. It takes awhile to sort them out and in the mean time you need a friend or a patient advocate.
There is little continuity of care and the insurance companies make many of the decisions and their bottom line is profit. Safest hospital is run by a religious order who have your best interest at heart. Sad to say they are going out of existence. Ann Trudo R.N.

Posted by: Ann | Jun 25, 2008 12:28:45 AM

I have had family and self as INpatients and always wanted, first and foremost, to feel that there were COMPETENT nurses giving the care. I'm not a hospital nurse, but I can imagine the workload and am not surprised at how bedside care certainly suffers, ie. no baths by staff, waiting for assistance for long periods, etc. I'm in long term care where call lights are answered within 3 minutes and care given ASAP, but that is the customer service point of view that is necessary to avoid legal problems in an arena where encouragement of litigation is advertised on TV! I think what I'm trying to say is I don't necessarily expect such prompt service from staff nurses when in hospital, so that has not been high on my list.

Posted by: Cindy Weaver | Jun 24, 2008 10:00:55 PM

I had a mastectomy and DIEP flap reconstruction at Georgetown University 7/10/07. I was in the surgical ICU for 5 days. I experienced excruciating pain from my IV in my hand to the point that I pulled it out and threw it on the floor because NOONE knew how to use my port-a-cath!!! My night nurse insisted on turning on the bright overheads every 3 a.m. check to take my temperature and pulse. And my medical condition was posted on my door with my name - so much for HIPPA! If I had deeper pockets I would sue this polace for their shabby patient care in the ICU. I only want competence and a little compassion - not a buch of folks who had to be prompted to wash their hands all the time.

Posted by: Kelly | Jun 24, 2008 6:52:58 PM

As a patient I really just want to feel safe and cared for. Going to the hospital can be scary, so feeling confident in your caregivers is huge. Now I think another good question is what do I want when it is my family memeber of friend in the hospital. In that case I expect a lot more. Just something else for nurses to keep in mind.

Posted by: Jeff | Jun 23, 2008 4:27:58 PM

For those of us who have been patients or had family members as patients, WHAT were your expectations of the nurses? Did they meet your needs? Or dropped you like a hat when you used the call bell for assistance?

Or did you receive one of a kind, select, SUPERB care from your nurse?

Is the general public (who are patients) treated in the same manner as those of us who are healthcare providers, but in-house-out-house patients? EQUALITY or not?

beka

Posted by: beka | Jun 19, 2008 2:53:38 PM

A question, please. What exactly do you mean by "patient?" Since I suspect we are all "patients" in some sense or another, my guess would be that you mean "the experience of being a[n] [IN]patient". However, when I read the results of the UK study (thanks for bringing this to my attention, by the way), they seem more geared to the experience of being an OUTpatient. Just wondering.

Posted by: hulatalulala | Jun 18, 2008 10:57:36 PM

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